Cesium-131 tile implants outperform standard radiation after brain metastasis surgery

The ROADS phase 3 trial (NCT04365374) compared surgical resection followed by immediate cesium-131 collagen tile implantation (TBRT) versus resection followed by standard post-operative stereotactic radiation (SRT) in 204 patients with newly diagnosed brain metastases requiring surgery. The trial reported that R+TBRT significantly improved time-to-surgical bed recurrence (hazard ratio 0.06) and surgical bed recurrence-free survival (hazard ratio 0.48) compared with R+SRT, with similar overall adverse event rates between arms (79.0% vs 80.7%). The authors concluded that R+TBRT demonstrated both non-inferiority and superiority to R+SRT for these outcomes.

Most relevant for: Patients with newly diagnosed brain metastases indicated for surgical resection.

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